It Turns Out that Telemedicine With Your Normal Primary Care Doctor is Better Than Some Random Telemedicine Jabroni

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A study that came out in JAMA not too long ago should surprise no one here. It turns out that doctors who have an established relationship with the patient will prescribe fewer antibiotics for a URI during a telemedicine visit:

In this analysis of almost 28,000 children with virtual visits for ARTIs, the researchers found fewer children received a diagnosis that warranted antibiotics during a primary care telehealth visit (19%) compared with a DTC telehealth visit (28%). Likewise, fewer patients received an antibiotic prescription from a PCP (29%) than a DTC provider (37%).

Here are the researcher’s thoughts on this:

“Primary care telehealth is integrated with the patient’s ongoing in-person care, so PCPs providing telehealth visits have access to patients’ prior records, have ongoing patient-provider relationships and have the ability to bring the patient into the office if the child needs a test or to be examined more closely,” she explained.

“Without these options, providers in virtual-only care settings might prescribe antibiotics ‘just in case’ more often, and they might perceive more pressure from parents to prescribe antibiotics in virtual-only settings.”

I am glad to see someone is studying this. Most telemedicine companies are a joke, handing out meds like candy from a vending machine. It’s been happening with antibiotics, antidepressants, weight loss drugs, and on and on. Oh, and it is usually not a doctor either. Now, imagine if this study had looked at DPC doctors to see their antibiotic prescription rate. I am sure it would blow their minds how low it would be.

Unfortunately, the senior author of the study said this:

According to Ray, the study highlights the importance of regulatory and payment policies that incentivize primary care telehealth and support more seamless integration of virtual and in-person appointments.

No, we do not need more policies and bureaucracy.

That seamless integration is called Direct Primary Care

About Douglas Farrago, MD

Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement. He is the author of three best-selling books on Direct Primary Care: The Official Guide to Starting Your Own Direct Primary Care Practice The Direct Primary Care Doctor’s Daily Motivational Journal Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices.Dr. Farrago sold his Direct Primary Care practice in October 2020 but continues to receive care there as a patient.